Not Guilty by Reason of Insanity: Getting Away with Murder?

The Not Guilty By Reason of Insanity (NGRI) finding doesn't occur as often as the media would have us believe.

As a forensic psychiatrist turned writer, I’m often asked about criminal issues and psychiatry, especially since I’ve written about these topics in both my fiction and non-fiction books. One of the questions I’m asked most frequently is, “How can someone who has committed a murder be found Not Guilty by Reason of Insanity.” Although this plea is rarely used, it is often hyped in the media.

NGRI cases make headlines either because the crimes committed were against famous people or were the most heinous crimes imaginable. Think of the murders committed by James Holmes, the Aurora, Colorado shooter, who snuck into the midnight screening of The Dark Night Rises and killed or wounded many innocent people.

Ironically, despite James Holmes being floridly psychotic, the jury did not accept his NGRI defense and he was sentenced to 12 life sentences and 3,318 additional years in prison for multiple offenses.

Not only are these cases very rare, they are often quite controversial. Think of John Hinckley, who shot President Regan.

Less than one percent of criminal defenses involve NGRI pleas, and of that number, very few are successful. So, the actual number of defendants who are found to be “not guilty” because of insanity, is very, very small.

The heart of the NGRI defense involves the concept that the person committing the crime lacked the capacity to differentiate right from wrong by virtue of brain damage, mental retardation, or some other affliction causing an inability to act within the law’s requirements. Consider, for example, a paranoid man who fervently believes the FBI or CIA is following him, and because of that delusional belief, shoots someone walking behind him on a dark street because his insanity drove him to perceive his own life was in danger. Or, take the case of the psychotic individual who hears the voice of God telling him to execute everyone he sees, an incident which actually occurred years ago on the Staten Island Ferry in New York City.

NGRI defenses are difficult to prove, and when they are presented, forensic psychiatrists are brought into court to testify about the defendant’s mental state at the time the crime was committed. The jury must consider the arguments presented by each side, and make its decision based on the psychiatric testimony offered.

Perhaps the biggest misconception about NGRI pleas is the popular belief that if found Not Guilty by Reason of Insanity, the defendant leaves court a free individual and in essence, got away with murder.

Not true.

If a jury concludes a defendant is NGRI, he or she is remanded to a state mental hospital for an indefinite period of time. That hospital confinement will very likely exceed the time which would have been served had the defendant been found guilty and sent to prison!

The acquitee (which is the term applied to those individuals who have been deemed NGRI) must undergo treatment in a locked psychiatric facility, which is part of the Department of Corrections in most states.

Once each year, a review board convenes to decide if the acquitee has been “restored to sanity.” The board is comprised of psychiatrists, psychologists, social workers and other mental health professionals who have had direct contact with the acquitee. And for the vast majority of acquitees, the annual meeting concludes with continued confinement, while being maintained on potent anti-psychotic medication. “Restoration of sanity” is rarely achieved.

In fact, the average stay in a locked mental institution for insanity acquitees is 35 years, whereas the prison term for these same crimes would be 20 years.

Recently, John Hinckley was granted a provisional release from Washington’s St. Elizabeth Hospital, where he’d been committed since 1982. This “convalescent leave” has been granted because he is no longer viewed as a threat to himself or others. As such, he is under severe restrictions and most remain in psychiatric treatment in order to remain free.

Had he been convicted of the crimes he committed, he would have long since been released from prison with no restrictions on his movements or associations.

A successful NGRI plea doesn’t mean the defendant got away with a thing. In fact, he often pays a higher price for the crime committed.

About Mark Rubinstein

Mark Rubinstein, M.D., an award-winning novelist, a physician and psychiatrist, is the author of a non-fiction book, Bedlam’s Door: True Tales of Madness and Hope. For more information, please visit his website, read his book, and follow him on Twitter and Facebook.